|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,120.79 |
| Max. Negotiated Rate |
$3,029.70 |
| Rate for Payer: Aetna Commercial |
$2,726.73
|
| Rate for Payer: Aetna Commercial |
$4,090.10
|
| Rate for Payer: ASR ASR |
$4,408.21
|
| Rate for Payer: ASR ASR |
$2,938.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,523.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,348.93
|
| Rate for Payer: BCN Commercial |
$2,348.93
|
| Rate for Payer: BCN Commercial |
$3,523.39
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$4,271.88
|
| Rate for Payer: Cofinity Commercial |
$2,847.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Healthscope Commercial |
$4,544.55
|
| Rate for Payer: Healthscope Commercial |
$3,029.70
|
| Rate for Payer: Healthscope Whirlpool |
$4,408.21
|
| Rate for Payer: Healthscope Whirlpool |
$2,938.81
|
| Rate for Payer: Mclaren Commercial |
$4,090.10
|
| Rate for Payer: Mclaren Commercial |
$2,726.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,575.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,120.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,181.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,999.20
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,545.53 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,066.73
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,653.38
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna Commercial |
$1,863.00
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$2,007.90
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.87
|
| Rate for Payer: BCN Commercial |
$1,604.87
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,945.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,070.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,007.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,863.00
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,847.63
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,478.10
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,821.60
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,449.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna Commercial |
$1,863.00
|
| Rate for Payer: ASR ASR |
$2,007.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.87
|
| Rate for Payer: BCN Commercial |
$1,604.87
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,945.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Healthscope Commercial |
$2,070.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,007.90
|
| Rate for Payer: Mclaren Commercial |
$1,863.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,821.60
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,674.34 |
| Rate for Payer: Aetna Commercial |
$2,406.91
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,594.11
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.42
|
| Rate for Payer: BCN Commercial |
$2,073.42
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,674.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,594.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,406.91
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,219.63
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,775.70
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,353.42
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,872.04 |
| Max. Negotiated Rate |
$2,674.34 |
| Rate for Payer: Aetna Commercial |
$2,406.91
|
| Rate for Payer: ASR ASR |
$2,594.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.42
|
| Rate for Payer: BCN Commercial |
$2,073.42
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,674.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,594.11
|
| Rate for Payer: Mclaren Commercial |
$2,406.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,353.42
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.36
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.09
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,545.53 |
| Max. Negotiated Rate |
$2,207.90 |
| Rate for Payer: Aetna Commercial |
$1,987.11
|
| Rate for Payer: ASR ASR |
$2,141.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.78
|
| Rate for Payer: BCN Commercial |
$1,711.78
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$2,075.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$2,207.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,141.66
|
| Rate for Payer: Mclaren Commercial |
$1,987.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,942.95
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna Commercial |
$1,863.00
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$2,007.90
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.87
|
| Rate for Payer: BCN Commercial |
$1,604.87
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,945.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,070.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,007.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,863.00
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,770.67
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,416.54
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,821.60
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,449.00 |
| Max. Negotiated Rate |
$2,070.00 |
| Rate for Payer: Aetna Commercial |
$1,863.00
|
| Rate for Payer: ASR ASR |
$2,007.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.87
|
| Rate for Payer: BCN Commercial |
$1,604.87
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,945.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Healthscope Commercial |
$2,070.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,007.90
|
| Rate for Payer: Mclaren Commercial |
$1,863.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,821.60
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,872.04 |
| Max. Negotiated Rate |
$2,674.34 |
| Rate for Payer: Aetna Commercial |
$2,406.91
|
| Rate for Payer: ASR ASR |
$2,594.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.42
|
| Rate for Payer: BCN Commercial |
$2,073.42
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,674.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,594.11
|
| Rate for Payer: Mclaren Commercial |
$2,406.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,353.42
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,674.34 |
| Rate for Payer: Aetna Commercial |
$2,406.91
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,594.11
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.42
|
| Rate for Payer: BCN Commercial |
$2,073.42
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,674.34
|
| Rate for Payer: Healthscope Whirlpool |
$2,594.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,406.91
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,246.30
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,797.04
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,353.42
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,346.00
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,642.20 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Aetna Commercial |
$2,111.40
|
| Rate for Payer: ASR ASR |
$2,275.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,818.85
|
| Rate for Payer: BCN Commercial |
$1,818.85
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,205.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Healthscope Commercial |
$2,346.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,275.62
|
| Rate for Payer: Mclaren Commercial |
$2,111.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,064.48
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,346.00
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Aetna Commercial |
$2,111.40
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,275.62
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,818.85
|
| Rate for Payer: BCN Commercial |
$1,818.85
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,205.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,346.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,275.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,111.40
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,634.70
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.76
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,064.48
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,497.30 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,925.10
|
| Rate for Payer: ASR ASR |
$2,074.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.37
|
| Rate for Payer: BCN Commercial |
$1,658.37
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cofinity Commercial |
$2,010.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,711.20
|
| Rate for Payer: Healthscope Commercial |
$2,139.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,074.83
|
| Rate for Payer: Mclaren Commercial |
$1,925.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,818.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,497.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,882.32
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,139.00 |
| Rate for Payer: Aetna Commercial |
$1,925.10
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$2,074.83
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.37
|
| Rate for Payer: BCN Commercial |
$1,658.37
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cofinity Commercial |
$2,010.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,711.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,139.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,074.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$1,925.10
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,818.15
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,497.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,552.10
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.68
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,882.32
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
IP
|
$2,621.90
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,835.33 |
| Max. Negotiated Rate |
$2,621.90 |
| Rate for Payer: Aetna Commercial |
$2,359.71
|
| Rate for Payer: ASR ASR |
$2,543.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.76
|
| Rate for Payer: BCN Commercial |
$2,032.76
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cofinity Commercial |
$2,464.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,097.52
|
| Rate for Payer: Healthscope Commercial |
$2,621.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,543.24
|
| Rate for Payer: Mclaren Commercial |
$2,359.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,228.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,835.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,307.27
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
OP
|
$2,621.90
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,621.90 |
| Rate for Payer: Aetna Commercial |
$2,359.71
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$2,543.24
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.76
|
| Rate for Payer: BCN Commercial |
$2,032.76
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cofinity Commercial |
$2,464.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,097.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$2,621.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,543.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,359.71
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,228.62
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,835.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,769.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,415.30
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,307.27
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
OP
|
$3,378.08
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$3,378.08 |
| Rate for Payer: Aetna Commercial |
$3,040.27
|
| Rate for Payer: Aetna Commercial |
$2,026.84
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$3,276.74
|
| Rate for Payer: ASR ASR |
$2,184.49
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,619.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.01
|
| Rate for Payer: BCN Commercial |
$1,746.01
|
| Rate for Payer: BCN Commercial |
$2,619.03
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cofinity Commercial |
$3,175.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,378.08
|
| Rate for Payer: Healthscope Commercial |
$2,252.05
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$3,040.27
|
| Rate for Payer: Mclaren Commercial |
$2,026.84
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.37
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,634.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,634.70
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.76
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.71
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
IP
|
$3,378.08
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,364.66 |
| Max. Negotiated Rate |
$3,378.08 |
| Rate for Payer: Aetna Commercial |
$3,040.27
|
| Rate for Payer: Aetna Commercial |
$2,026.84
|
| Rate for Payer: ASR ASR |
$2,184.49
|
| Rate for Payer: ASR ASR |
$3,276.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,619.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.01
|
| Rate for Payer: BCN Commercial |
$2,619.03
|
| Rate for Payer: BCN Commercial |
$1,746.01
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$3,175.40
|
| Rate for Payer: Cofinity Commercial |
$2,116.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Healthscope Commercial |
$3,378.08
|
| Rate for Payer: Healthscope Commercial |
$2,252.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,184.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.74
|
| Rate for Payer: Mclaren Commercial |
$2,026.84
|
| Rate for Payer: Mclaren Commercial |
$3,040.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,981.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.71
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
IP
|
$3,167.10
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,216.97 |
| Max. Negotiated Rate |
$3,167.10 |
| Rate for Payer: Aetna Commercial |
$2,850.39
|
| Rate for Payer: Aetna Commercial |
$1,900.26
|
| Rate for Payer: ASR ASR |
$2,048.06
|
| Rate for Payer: ASR ASR |
$3,072.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,455.45
|
| Rate for Payer: BCN Commercial |
$1,636.97
|
| Rate for Payer: BCN Commercial |
$2,455.45
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$1,984.72
|
| Rate for Payer: Cofinity Commercial |
$2,977.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Healthscope Commercial |
$3,167.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,072.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,048.06
|
| Rate for Payer: Mclaren Commercial |
$1,900.26
|
| Rate for Payer: Mclaren Commercial |
$2,850.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,787.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,858.03
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna Commercial |
$1,900.26
|
| Rate for Payer: Aetna Commercial |
$2,850.39
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$3,072.09
|
| Rate for Payer: ASR ASR |
$2,048.06
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,455.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.97
|
| Rate for Payer: BCN Commercial |
$2,455.45
|
| Rate for Payer: BCN Commercial |
$1,636.97
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,984.72
|
| Rate for Payer: Cofinity Commercial |
$2,977.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Healthscope Commercial |
$3,167.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,072.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,048.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$2,850.39
|
| Rate for Payer: Mclaren Commercial |
$1,900.26
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,692.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,552.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,552.10
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,241.68
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,858.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,787.05
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$2,533.57 |
| Rate for Payer: Aetna Commercial |
$2,280.21
|
| Rate for Payer: Aetna Commercial |
$3,420.32
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Aetna Medicare |
$341.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: ASR ASR |
$3,686.35
|
| Rate for Payer: ASR ASR |
$2,457.56
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,964.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,946.42
|
| Rate for Payer: BCN Commercial |
$1,964.28
|
| Rate for Payer: BCN Commercial |
$2,946.42
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$2,381.56
|
| Rate for Payer: Cofinity Commercial |
$3,572.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,533.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,686.35
|
| Rate for Payer: Healthscope Whirlpool |
$2,457.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$341.84
|
| Rate for Payer: Mclaren Commercial |
$2,280.21
|
| Rate for Payer: Mclaren Commercial |
$3,420.32
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Commercial |
$376.02
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicaid |
$186.99
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,769.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,769.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,415.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,415.30
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,344.32
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: VA VA |
$341.84
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
IP
|
$3,800.36
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,660.25 |
| Max. Negotiated Rate |
$3,800.36 |
| Rate for Payer: Aetna Commercial |
$3,420.32
|
| Rate for Payer: Aetna Commercial |
$2,280.21
|
| Rate for Payer: ASR ASR |
$3,686.35
|
| Rate for Payer: ASR ASR |
$2,457.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,946.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,964.28
|
| Rate for Payer: BCN Commercial |
$2,946.42
|
| Rate for Payer: BCN Commercial |
$1,964.28
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,381.56
|
| Rate for Payer: Cofinity Commercial |
$3,572.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Healthscope Commercial |
$3,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,533.57
|
| Rate for Payer: Healthscope Whirlpool |
$2,457.56
|
| Rate for Payer: Healthscope Whirlpool |
$3,686.35
|
| Rate for Payer: Mclaren Commercial |
$2,280.21
|
| Rate for Payer: Mclaren Commercial |
$3,420.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,344.32
|
|
